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Yellow fever – French Guiana, France

On 23 July 2020, the France IHR National Focal Point reported a confirmed autochthonous (locally acquired) case of yellow fever in a 14-year-old male in French Guiana. On 17 July 2020, the case was laboratory confirmed at the French National Reference Centre for arboviruses, Institute Pasteur Cayenne.

The case-patient had severe disability, and developed dengue-like symptoms on 12 July. On 16 July, he was hospitalized in an intensive care unit in Cayenne, French Guiana, with consciousness disorders and acute liver failure, and died on 19 July.

Plague – Democratic Republic of the Congo

The health zone of Rethy in Ituri province, the Democratic Republic of the Congo, has seen an upsurge of plague cases since June 2020. The first case, a 12-year-old girl, reported to a local health centre on 12 June experiencing a headache, fever, cough, and an enlarged lymph node. She died on the same day and further deaths from the community due to suspected cases of plague were subsequently reported.

From 11 June though 15 July, six out of 22 health areas have been affected within Rethy health zone (11 villages), with a total of 45 cases including nine deaths (case fatality rate: 20%). All nine (9) cases who died presented with signs of headache, high fever, and painful nodes; four (4) out of the nine (9) cases had cough.

Influenza A(H1N2) variant virus – Brazil

On 22 June 2020, the International Health Regualtions (IHR) Focal Point (FP) of Brazil shared a preliminary report with the Panamerican Health Organization, the WHO Regional Office for the Americas of a human infection with Influenza A(H1N2) variant virus (A(H1N2)v). According to the report, the patient, a 22-year-old female, with no comorbidities, worked in a swine slaughterhouse in Ibiporã Municipality, Paraná State, and developed an influenza-like illness on 12 April 2020. The patient initially sought medical care on 14 April and a respiratory specimen was obtained on 16 April as part of routine surveillance activities. The patient was treated with oseltamivir, was not hospitalized and has recovered.

A real-time RT-PCR test conducted at the public health laboratory identified a non-subtypable influenza A virus. In May 2020, the specimen was forwarded to the Laboratory of Respiratory Virus and Measles, Oswaldo Cruz Institute (FIOCRUZ per its acronym in Portuguese), a national influenza reference laboratory, in Rio de Janeiro. On 22 June, genetic sequencing characterized this virus as an influenza A(H1N2)v virus.

Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

Between 1 April and 31 May 2020, the National IHR Focal Point of Saudi Arabia reported nine new cases of MERS-CoV infection, including five deaths. The cases were reported from Riyadh (seven cases), Assir (one case) and Northern (one case) Regions. Most cases were and ages of the reported cases ranged from 40 to 96 years.

Of the cases reported in Riyadh six were from a hospital outbreak in the region between 21 and 31 May 2020: an index case who was a newly admitted patient, and five secondary cases identified through contact tracing. One of the secondary cases was a health care worker and the other four were in-patients admitted due to other health conditions. All four in-patients were bedridden and above 75 years of age. All reported cases had comorbidities with the exception of the healthcare worker.

Ebola virus disease – Democratic Republic of the Congo

On 25 June 2020, the Minister of Health of the Democratic Republic of the Congo declared the end of the Ebola Virus Disease (EVD) outbreak in North Kivu, Ituri and South Kivu Provinces . In accordance with WHO recommendations, the declaration was made more than 42 days after the last person who contracted EVD in this outbreak tested negative twice and was discharged from care.

The outbreak was declared on 1 August 2018 following investigations and laboratory confirmation of a cluster of EVD cases in North Kivu Province. Further investigations identified cases in Ituri and North Kivu Provinces with dates of symptom onset from May to August 2018. In 2019, the outbreak subsequently spread to South Kivu Province, and on 17 July 2019, the WHO Director-General declared the outbreak a Public Health Emergency of International Concern. In the Democratic Republic of the Congo, 11 outbreaks have been recorded since the first recognized outbreak in 1976. The 10th EVD outbreak in North Kivu, Ituri and South Kivu Provinces was the country's longest EVD outbreak and the second largest in the world after the 2014–2016 EVD outbreak in West Africa.

Ebola virus disease – Democratic Republic of the Congo

No new confirmed cases of Ebola virus disease (EVD) have been reported in Ituri, North Kivu and South Kivu Provinces of the Democratic Republic of the Congo since 27 April 2020 (Figure 1). While this is a positive development, there remains a risk of re-emergence of EVD. It is critical to maintain surveillance and response operations in the period leading up to the declaration of the end of the outbreak, as well as after the declaration – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak .

From 11 to 16 June 2020, an average of 2939 alerts were reported per day, of which 2788 (about 95%) were investigated within 24 hours. Of these, an average of 453 alerts were validated as suspected cases each day, requiring specialized care and laboratory testing to rule-out EVD. The number of reported and validated alerts has remained stable in recent weeks. Timely testing of suspected cases continues to be provided from eight laboratories. From 8 to 14 June 2020, 3219 samples were tested including 2513 blood samples from alive, suspected cases; 324 swabs from community deaths; and 382 samples from re-tested patients. Overall, the number of samples tested by the laboratories increased by 3% compared to the previous week.

Yellow fever – Gabon

On 15 April 2020, WHO received information regarding a confirmed case of yellow fever in Magandi village, Tchibanga city in Nyanga Province of southern Gabon, 590 km from the capital, Libreville.

The case is an 83-year-old male with no known vaccination history for yellow fever. He had onset of symptoms on 30 January 2020 and presented to a health facility on 2 February 2020 with abdominal pain and jaundice. Between 2 February and 9 April, he consulted the Urban Health Centre in Tchibanga, the Christian Alliance Hospital in Bongolo and the University hospital in the capital Libreville where the case received anti-malarial treatment and remained hospitalized until his death on 9 April 2020. On 14 April 2020, the laboratory results received from the WHO Regional Reference Laboratory at the Institute Pasteur in Dakar, Senegal, confirmed yellow fever infection, by seroneutralisation test. The additional differential diagnostic tests performed were negative for dengue, West Nile fever, chikungunya, Crimean-Congo Haemorrhagic fever, Zika and Rift Valley fever.

Ebola virus disease – Democratic Republic of the Congo

No new confirmed cases of Ebola virus disease (EVD) have been reported in Ituri, North Kivu and South Kivu Provinces of the Democratic Republic of the Congo since 27 April 2020 (Figure 1).

The source of infection of the cluster reported in April 2020 remains unconfirmed.

Yellow fever – Togo

On 20 April 2020, WHO received information regarding a confirmed yellow fever case in Galangashie health area, located 30 km from Mango village, Oti district, Savanes region in the northern part of Togo.

The case is a 55-year-old woman with no vaccination history for yellow fever. She had onset of symptoms on 31 January 2020 and presented to a health facility on 3 February 2020 with fever and aches. The following day she developed jaundice and a blood sample was taken. On 7 February , the blood sample was transported to the national laboratory. On 10 February , the sample from the case was received at the national laboratory and test results on 17 March were Immunoglobulin M (IgM) positive for yellow fever. The positive yellow fever result was confirmed by the Institute Pasteur in Dakar Senegal, a yellow fever reference laboratory on 14 April 2020 by seroneutralisation.

Ebola virus disease – Democratic Republic of the Congo

No new confirmed cases of Ebola virus disease (EVD) have been reported in Ituri, North Kivu and South Kivu Provinces of the Democratic Republic of the Congo since 27 April 2020 (Figure 1).

The source of infection of the cluster reported in April 2020 remains unconfirmed.

Ebola virus disease – Democratic Republic of the Congo

On 31 May 2020, WHO received information that between 18 and 30 May, four deaths were reported from the same quarter (quartier Air Congo) in Wangata Health Zone, Mbandaka city, Equateur Province, the Democratic Republic of the Congo.

Ebola virus disease – Democratic Republic of the Congo

From 20 to 26 May 2020, no new cases of Ebola virus disease (EVD) have been reported from the Democratic Republic of the Congo (Figure 1).

Dracunculiasis (Guinea worm disease) – Ethiopia

Between 2 and 8 April 2020, six suspected human cases of dracunculiasis in Duli village, Gog district, Gambella region, Ethiopia, were reported to WHO.

Ebola virus disease – Democratic Republic of the Congo

From 13 to 19 May 2020, no new cases of Ebola virus disease (EVD) have been reported from North Kivu Province, Democratic Republic of the Congo.

Ebola virus disease – Democratic Republic of the Congo

From 6 to 12 May 2020, no new cases of Ebola virus disease (EVD) have been reported from North Kivu Province, Democratic Republic of the Congo (Figure 1). Since the resurgence of the outbreak on 10 April 2020, seven confirmed cases have been reported from Kasanga, Malepe and Kanzulinzuli Health Areas in Beni Health Zone. Of these, one is receiving care at the Beni Ebola treatment centre (ETC), one who was receiving care at the ETC recovered and was discharged, and one remains in the community, 35 days after symptom onset. Efforts to locate this individual are being undertaken to test and provide care for this person. Four of the people confirmed to have Ebola died, including two community deaths and two deaths in the ETC in Beni. So far, no definitive source of infection has been identified.

As of 12 May, 90 contacts are currently under surveillance, of which 41 are high-risk contacts who had direct contact with body fluids of the last confirmed case. All contacts have exited their high-risk period (seven to 13 days after last exposure). Contacts from the previous six cases reported in April have exited their follow-up period. Of the 41 high-risk contacts, 37 have been vaccinated. A total of 1486 people have been vaccinated in Beni and Karisimbi since 10 April 2020.

Ebola virus disease – Democratic Republic of the Congo

From 29 April to 5 May 2020, no new cases of Ebola virus disease (EVD) have been reported from North Kivu Province, Democratic Republic of the Congo.

Measles – Burundi

Burundi has been experiencing an increase in the number of confirmed cases of measles since November 2019. This outbreak initially started in a refugee transit camp (Centre de transit de Cishemere, Cibitoke Health district), whose inhabitants had arrived from measles-affected provinces of the Democratic Republic of Congo. Refugees spend 21 days in the Transit Camp of Cishemere before they are sent to permanent camps in Nyankanda and Bwagiriza refugee camps in Butezi, Kavumu camp of Cankuzo, Garsowe camp of Muyinga and Mulumba camp at Kiremba.

The outbreak was identified when suspected measles cases had been reported by the local residents in the surrounding areas, highlighting pockets of under-vaccinated populations. According to WHO/UNICEF 2018 estimates, measles first dose vaccination coverage is relatively high (88%), and slightly lower for the second dose (77%). However, this does not reflect the vaccination coverage of incoming refugees.

Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

From 1 through 31 March 2020, the National IHR Focal Point of Saudi Arabia reported 15 additional cases of MERS-CoV infection, including five associated deaths. The cases were reported from Riyadh (7 cases), Makkah (4 cases), Najran (3 cases), and Al Qassim (1 case) regions.

The link below provides details of the 15 reported cases.

Ebola virus disease – Democratic Republic of the Congo

From 22 to 28 April 2020, one new confirmed case of Ebola virus disease (EVD) was reported from Beni Health Zone in North Kivu Province, Democratic Republic of the Congo (Figure 1). This person was listed as a contact of a confirmed case, a family member who was reported on 17 April. The person was vaccinated on 20 April and was followed by the contact tracing team, though not on a regular basis due to insecurity.

Since the resurgence of the outbreak on 10 April 2020, seven confirmed cases have been reported, all from Beni Health Zone. Of these, one is receiving care at the Beni Ebola treatment centre (ETC), one who was receiving care at the ETC recovered and was discharged, and one remains in the community. Response teams are engaging with the community in order to try to bring that person to the ETC for access to treatment and supportive care, and to prevent further transmission in the community. Four of the people confirmed to have Ebola died, including two community deaths and two deaths in the ETC in Beni.

Measles – Mexico

Mexico is experiencing a measles outbreak. Between 1 January and 2 April 2020, 1,364 probable¹cases of measles were reported, of which 124 were laboratory confirmed, 991 were discarded and 328 remain under investigation. The age of the confirmed measles cases ranged from three months to 68 years (median=20 years), and 59% were male. Analysis conducted by the National Reference Laboratory (InDRE) identified the genotype D8 (similar to other countries in the Region), linage MVs/GirSomnath.IND/42.16/ for 17 of the confirmed cases.

Of the 124 confirmed cases, 105 were in Mexico City, 18 in Mexico State, and one in Campeche State; the following is a summary of the epidemiological situation in each: